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Liver cancer

CISS relies strongly in its evaluations below on impartial analyses by the International Cochrane Collaboration and the British Medical Journal’s Clinical Evidence Group – two groups of researchers who specialise in Evidence Based Medicine.Conventional medicine supports the paradigm that the tumour is the first stage of cancer, therefore, treating and removing the tumour should cure the cancer. Unfortunately statistics will show this is rarely the case. Conventional medicine also advocates treatment should only be used if supported by appropriate clinical trials showing efficacy. In fact evidence based medicine suggests that the only reliable evidence needs to come from properly run randomised controlled trials (RCTs). Again, with conventional cancer treatment, this is generally not the case.

The following is based on the conventional cancer paradigm.

The liver has many important functions in the body. It cleans toxins from the blood, makes bile that helps digest fat, makes substances that help blood clot, and makes, stores and releases sugar for energy.

Primary liver cancer is cancer that starts in the liver. The most common type of primary liver cancer is hepatocellular carcinoma, which occurs in the tissue of the liver. When cancer starts in other parts of the body and spreads to the liver, it is called metastasis.

Liver cancer is rare in children and teenagers, but there are two types of liver cancer that can form in children. Hepatoblastoma occurs in younger children, and hepatocellular carcinoma occurs in older children and teenagers.

The bile ducts are tubes that carry bile between the liver and gallbladder and the intestine. Bile duct cancer is also called cholangiocarcinoma. When it begins in the bile ducts inside the liver, it is called intrahepatic cholangiocarcinoma. When it begins in the bile ducts outside the liver, it is called extrahepatic cholangiocarcinoma. Extrahepatic cholangiocarcinoma is much more common than intrahepatic cholangiocarcinoma. (National Cancer Institute)

Risks: Infection with Hepatitis B and C (In Australia around half of all liver cancers is caused by the hepatitis B virus).

Cirrhosis of the liver (Cirrhosis is where healthy liver tissue is replaced by scar tissue, usually caused by hepatitis C or alcohol abuse).

Aflotoxin (a poison from a fungus that can grow on foods, such as grains and nuts that have not been properly stored). (National Cancer Institute)

Signs and Symptoms: Primary liver cancer doesn’t tend to cause symptoms in the early stages, but they may appear as the cancer grows or becomes advanced. Secondary liver cancers may cause similar symptoms. Symptoms can include:

  • Weakness and tiredness (fatigue)
  • Pain in the upper right side of the abdomen.
  • Severe abdominal pain.
  • Appetite loss and feeling sick (nausea).
  • Weight loss
  • Yellowing of the skin and eyes (jaundice)
  • Pale bowel motions.
  • Swelling of the abdomen (ascites).
  • (Australian Council Cancer).

Treatment:

Primary liver cancer

1. Tumour ablation – a treatment that destroys the tumour using heat (radiofrequency or microwave ablation) via a needle inserted through the skin or a surgical cut. Ablation works best when there are only one or two small tumours (less than 3cm). It is rarely used on secondary liver cancer.

Less common types of tumour ablation are done with alcohol and cryotherapy. With alcohol ablation, pure alcohol is inserted directly onto the tumour with a needle under guided ultrasound. Cryotherapy is a procedure that freezes the cancer cells to kill them. A probe is inserted into the centre of the tumour (via a cut made in the abdomen) that releases liquid nitrogen to freeze and kill the cells.

2. Chemotherapy – the use of toxic drugs delivered directly into the cancer, known as transarterial chemoembolisation (TACE). Systemic chemotherapy is generally not used in primary liver cancer unless it has spread to other parts of the body. Sometimes it is used for palliative treatment to slow down the cancer growth and reduce pain.

3. Surgery – used for only about 5% of people with primary liver cancer, only a small number of people are suitable. It may be possible to use surgery for secondary liver cancer. Please note: there is little evidence that surgery for cancer has any benefit on increased percentage 5 year survival except in cases where the tumour is in a life threatening position (The efficacy of surgical treatment of cancer, DJ Benjamin).

4. Biological therapy – are a range of treatments derived from natural substances in the body, which are concentrated and purified for use as drugs. The therapies work against cancer cells by either stopping their growth and the way they function, or by helping the body’s immune system destroy them. They can be used after or in conjunction with other treatments for both primary and secondary liver cancer.

5. Radioembolisation – (also known as selective internal radiation therapy or SIRT) is a type of treatment that targets liver tumours directly with high doses of internal radiation placed in tiny radioactive beads. The beads are inserted through a catheter that leads from your groin to your liver and takes about 60 minutes. You may require a CT scan and lung scans, and you will have an angiogram prior to SIRT to determine bead placement. SIRT is used for both primary and secondary liver cancers when the tumours cannot be removed by surgery or if there are many small tumours spread throughout the liver.

6. Endoscopic stent – sometimes cancer in the liver can obstruct the bile ducts which leads to bile build-up in the liver. This can cause symptoms of jaundice (yellowish skin, itchiness, pale stools, dark urine). Your doctor may recommend a stent (a thin tube) be placed in your liver to drain the bile and ease the symptoms. (NSW Cancer Council)

The above therapies all come with risks and side effects which should be discussed in detail by your treating physician.

Before deciding on one of these treatments you would benefit from asking your physician three questions:

Question 1: What are my treatment options? – these should include doing nothing.

Question 2: What are the possible outcomes of those options? – including benefits and side effects.

Question 3: How likely is each of the outcomes to occur?

If your doctor or other health practitioner cannot answer these questions, or shows that he or she is not comfortable with you asking these questions, it raises the question as to whether they are practising evidence based medicine and you should consider getting another opinion.

These three questions can be expanded.

Alternative Cancer Therapies

As mentioned above, conventional medicine supports the paradigm that the tumour is the first stage of cancer; therefore treating and removing the cancer should cure the cancer.

Another paradigm believes that cancer is a systemic disease and the tumour is in fact a late stage symptom, element or manifestation of that disease. Therefore treating the disease should be systemic and wholistic (meaning treating the whole body) and should include the following principles:

  1. Treatment should cause no harm
  2. Treatment should be Wholistic (ie consider the whole person – body, mind, emotions and spirit)
  3. The person with cancer needs to take control of their own health.

This latter paradigm is supported by CISS (See Introduction to CISS)

Alternative cancer therapies are generally consistent with the above principles. In fact, those believed to be most effective in controlling cancer – psychotherapy and immunotherapy – also have strong evidence from randomised controlled trials.

There are approximately 200 other alternative cancer therapies that have been shown or anecdotally reported to help a person with cancer have reduced morbidity and mortality. What is important in any cancer treatment is to both understand and believe in your chosen therapy.

There are a few alternative cancer therapies claimed to produce benefits with liver cancer. Those claimed to have the most benefits include:

  • Psychotherapy

Although there were no patients with liver cancers enrolled in the psychotherapy trials, psychotherapy was found to provide survival benefits in all types of solid tumour cancers tested, so liver cancer would not be expected to be an exception.

  • Immunotherapy
  • Iscador (Mistletoe extract)

Similarly, although there were not enough liver cancer patients among those in the trials of Iscador therapy, patients with most types of cancer showed significant survival benefits from this therapy so those with liver cancers would not be expected to have responded differently.

  • Issels’ Wholebody Therapy

Although not based on RCTs the most successful therapy for late stage cancers was Issels’ Whole Body Therapy that focussed on restoring the body’s immune systems. Wholebody immunotherapy was used by Josef Issels up to the 1970s.

It was estimated that a representative sample (252) of 750 Issels patients with late stage cancers who had attended his clinic up to May 1954, of whom 11 (4.4%) had late stage liver cancer, showed a 16.6% five year survival following his treatment and 15% 15 years survival. One of those with liver cancer was among those who survived 15 years.

References: Issels, J. Immunotherapy in Progressive Metastatic Cancer – A Fifteen-Year Follow-up. Clinical Trials Journal, August 1970: 357-365 – editorial by Phillips S. Dr Joseph Issels and the Ringberg Klinik. Clinical Trials Journal. August 1970: 355-56.

In Liver cancer, Ralph Moss (Cancer Therapy, The Independent Consumers Guide to Non-Toxic Treatment and Prevention) reports the following alternative therapies have been shown to benefit.

1. Coley’s Toxins – One of the most remarkable developments in the history of cancer therapy was the discovery by William B. Coley, MD in the late 19th century of an all natural method of treating and even curing cancer. As chief bone surgeon at Memorial Hospital, Coley initiated a forty year experiment in the use of bacterial toxins (mixed bacterial vaccine) in the treatment of cancer.

The toxins cause profound, if transient, biological effects. This can include a rise in temperature from 0.5 to 6 degrees, a pulse of 100 to 106, chills, trembling and headaches. Unlike conventional chemotherapy such side effects, while unpleasant for the patient, are not emblematic of an immunity – destroying process. Quite the opposite: they are the result of pushing the immune function to the limit of excitability. The increase in body temperature seems to function as a biological form of heat therapy.

Between 1985 and 1988, the toxins (or mixed bacterial vaccine, as they are now frequently called) were used as part of a combination treatment for liver cancer. Thirty eight patients who were receiving conventional therapy (surgery, radiation, cisplatin, etc) were randomised to receive, or not receive, Coley’s toxins. In every case, survival rates were better for the group also receiving toxins compared to those receiving only conventional therapy.

Reference: Zhao YT, et al. Preliminary result of mixed bacterial vaccine as adjuvant treatment of hepatocellular carcinoma. Med Oncol & Tumor Pharmcother. 1991;8:23-28.

2. Evening Primrose – Evening primrose oil is extracted from the common evening primrose, an annual plant found in wastelands and dry meadows in the eastern half of the US. Evening primrose oil has an abundant source of gamma-linolenic acid (GLA), this is the form the essential fatty acid, linoleic acid, takes when it is broken down in the body.

In 1980, Dr David F. Horrobin and scientists at the Efamol Research Institute in Kentville, Nova Scotia suggested that cancer cells cannot make a substance that converts linoleic into gamma-linolenic acid. This lack “may be the critical step in the malignant change in many forms of cancer”. By providing gamma linolenic acid, he said, physicians could normalise malignant cells and reverse cancer’s growth.

In 1980, Dr David Horrobin and scientists at the Efamol Research Institute in Kentville, Nova Scotia suggested that cancer cells cannot make a substance that converts linoleic into gamma-linolenic acid. This lack “may be the critical step in the malignant change in many forms of cancer”. By providing gamma linolenic acid, he said, physicians could normalise malignant cells and reverse cancer’s growth.

In a critical test of Horrobin’s theory, South African scientists showed that GLA supplements produced a “highly significant reduction” in the growth rate of human liver cancer cells in the test tube, up to 87 percent, and “requires urgent further investigation at all levels including trials in human cancer patients”.

References:

Van Der Merwe C, et al. The effect of gamma-linolenic acid, an in vitro cytostatic substance contained in evening primrose oil, on primary liver cancer. A double-blind placebo controlled trial. Prostaglandins Leukot Essent Fatty Acids. 1990;40:199-202.

Horrobin DF. The reversibility of cancer: the relevance of cyclic AMP,calcium, essential fatty acids and prostaglandin E1. Med Hypothesis. 1980;6:469-86.

Dippenaar N, et al. The reversibility of cancer: evidence that malignancy in human hepatoma cells is gamma-linplenic acid deficiency-dependent. S Med J.1982;62:683-5.

3. Tagamet – is a prescription drug that inhibits the formation of stomach acid. Because of this property, it is used in the treatment of duodenal ulrs. It is one of the most widely used drugs in the world.

It may have immune-stimulating activity, as well. In fact, in 1985 a scientist called Tagamet one of “the most promising developments in this field to date”.

In a Chinese study of primary liver carcinoma, the authors treated 30 patients with standard chemotherapy in combination with an immune booster called “Bai Niam Le” as well as levamisole and Tagamet. Natural Killer cell activity was “significantly elevated,” as were other beneficial parameters of the immune system. “Expansion of the tumour mass was checked,” Chinese scientists wrote, and “clinical conditions obviously improved”

References:

Drews J. The experimental and clinical use of immune – modulating drugs in the prophylaxix and treatment of infections. Infection.1985;13:S241-50.

Ling HY, et al. (Preliminary study of traditional Chinese medicine-Western medicine treatment of patients with primary liver carcinoma). Chung His I Chieh Ho Tsa Chih.1989;9:348-9.

4. Urea – is the chief end product of nitrogen metabolism in mammals. About one ounce of urea is excreted in human urine every day.

Studies done by a Dr Danapoulos ( a professor at the Medical School of Sthens University) showed a benefit of using oral urea for liver cancer. According to Danapoulos, urea taken orally goes to the liver and thus gives a “concentration of urea in the liver that has a greatly beneficial anti cancer effect”. Danapoulos has also said that if the liver is more than 30% involved with cancer, then urea treatment will have no effect. If the liver is not more than 30% involved, then urea can be an effective therapy.

References:

Danapoulos ED and Danopoulou IE. Regression of liver cancer with oral urea. Lancet.1974;1:132.

Danopoulos ED and Danopoulou IE. The results of ure treatment in liver malignancies. Clin Oncol.1975;1:341-50.

If you or someone close to you has just been diagnosed with oesophageal cancer, it is important you research and understand your chosen treatment, whether that be conventional, alternative or a mixture of both. For the best results your treatment should include physical, mental, emotional/psychological and spiritual treatment.

If you don’t know where to begin in your journey to wellness then we suggest you read Where To Start. This provides an introduction to the alternative approach to treating cancer and also information about some evidenced based alternative cancer treatments.

 

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